With a big focus on cervical cancer throughout the month of January, we take a look at the cover provided on a critical illness policy and how a cervical cancer claim would be assessed.
Cancer claims make up the largest percentage of claims paid on a critical illness policy by the UK’s insurance companies, making up around 65% of all claims (around 55% for males and 77% for females.)*
But when is a claim an eligible claim?
The Association of British Insurers have set the wording for the definition of a cancer claim as:
Any malignant tumour positively diagnosed with histological confirmation and characterised by the uncontrolled growth of malignant cells and the invasion of tissue. The term malignant tumour includes leukaemia, sarcoma and lymphoma except cutaneous lymphoma (lymphoma confined to the skin).
For the above definition, the following are not covered:
All cancers which are histologically classified as any of the following:
- cancer in situ;
- having borderline malignancy; or
- having low malignant potential
If the diagnosis meets this definition, a policy holder would receive 100% of the monies they are insured for.
However, with regular screening and advances in medicine it isn’t unusual for a female to find out they have early stage cervical cancer. If this means an abnormal smear, where there is an indication of abnormal pre-cancerous cells, then they wouldn’t be eligible to claim at this point. There are many treatments available to remove cells, but at this stage none of these treatments would be aggressive enough to warrant a claim on the policy.
However, over the years insurers have added cover for early stage cancers to their policies, giving policy holders an amount of additional cover should treatment be needed for an early stage cancer. In the case of cervical cancer, a claim for a carcinoma in situ of the cervix would trigger this, but only if the treatment needed is a trachelectomy or hysterectomy.
Insurers recognise that needing either of these operations would mean frequent hospital visits and a good few weeks off work to recover. To compensate for that they’ll pay the policy holder a percentage of their full cover amount, usually around 25%, up to a maximum of £25,000. This is paid in addition to the main cover, not deducted from it.
Lucy has a critical illness policy and her current level of cover is £80,000. She has been diagnosed with carcinoma in situ of the cervix and needs a hysterectomy to remove it.
Her insurer, Royal London, will pay her 25% of her sum assured under their terms and conditions, giving her £20,000.
A few months later Lucy finds out that the operation wasn’t successful and the cancer has now become invasive, meeting the definition of a full claim. Royal London will now pay Lucy the £80,000 that she is insured for. This means Lucy has received £100,000 from Royal London.
Some older policies may not have the additional cover for early stage cancers, so it is always worthwhile reviewing any existing cover with your adviser, to ensure it’s as comprehensive as it could be.
Insurance companies are there to provide financial help at a time when it is needed, however they have innovated over the years to provide practical and emotional support too. The type of support available could be:
- Support from a nurse adviser who will ensure you are fully aware of your condition and the treatment you’ll receive – a shoulder to lean on when you need it most
- Access to world leading specialists who can offer a second medical opinion
- Complimentary therapies to help you get back on your feet
For more information on critical illness cover please contact our specialists on:
01332 416470 or email@example.com
*CI Expert 2019